| NPI | 1396196549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2017022857) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-10699) |
| 207Q00000X Family Medicine (Licence: IL 188.000680) | |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2023-06-28 |